Provider Demographics
NPI:1700970332
Name:ZELLER, MATTHEW A (DO)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:A
Last Name:ZELLER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:25982 PALA
Mailing Address - Street 2:SUITE 180
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6719
Mailing Address - Country:US
Mailing Address - Phone:949-600-8990
Mailing Address - Fax:949-600-8998
Practice Address - Street 1:25982 PALA
Practice Address - Street 2:SUITE 180
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6719
Practice Address - Country:US
Practice Address - Phone:949-600-8990
Practice Address - Fax:949-600-8998
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-12-08
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Provider Licenses
StateLicense IDTaxonomies
CA20A8269207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI11082Medicare UPIN